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Are my hamstring tendons big enough for ACL Reconstruction?

I prefer to use hamstring tendon grafts for Anterior Cruciate Ligament (ACL) Reconstructions, but often wonder (and get asked all the time): “Will the graft be big enough?”


Came across a recent study in the American Journal of Orthopedics (June 2011) that looked at the relationship between sex, age, height, and body mass index (BMI) to hamstring graft diameter. In general males had adequate hamstring graft size / diameter and women typically had smaller hamstring tendons than men.


Age and BMI did not correlate with hamstring graft diameter in women. Height correlated to graft diameter in women; women shorter than 65 inches had significantly smaller hamstring graft diameters than those women 65 inches and taller.


In men, age and height did not have any correlation. BMI greater than 25 correlated with larger graft diameter, but BMI less than 18 did not predict graft sizes that were too small.


Study concluded that alternative graft options (patellar tendon and cadaver) should be considered in women less than 65 inches tall.


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